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Gong X, Xu J, He Y, Zou G, Liu J. Socioeconomic inequalities in human papillomavirus knowledge and vaccine uptake: evidence from a cross-sectional study in China. Front Public Health 2024; 12:1399192. [PMID: 38993697 PMCID: PMC11236539 DOI: 10.3389/fpubh.2024.1399192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/14/2024] [Indexed: 07/13/2024] Open
Abstract
Objective Providing the human papillomavirus (HPV) vaccine is effective to eliminate the disparity in HPV-related cancers. It is unknown regarding inequality in the distribution of HPV vaccination in China since the vaccine was licensed and approved for use in 2016. This study aimed to examine socioeconomic inequalities in HPV-related knowledge and vaccination and identified factors associated with such inequalities. Methods Self-administered questionnaires measuring HPV-related knowledge and vaccine uptake were completed by 1,306 women through online survey platform. HPV knowledge was assessed using a 12-item question stem that covered the hazards of HPV infection, HPV vaccine dosage, benefits, and protection. Cluster analysis by combining monthly household income, educational level, and employment status was used to identify socioeconomic status (SES) class. The concentration index (CI) was employed as a measure of socioeconomic inequalities in HPV-related knowledge and vaccination. Linear regression and logistic regression were established to decompose the contributions of associated factors to the observed inequalities. Results The CI for HPV-related knowledge and vaccine uptake was 0.0442 and 0.1485, respectively, indicating the higher knowledge and vaccination rate were concentrated in groups with high SES. Education and household income made the largest contribution to these inequalities. Age, residency and cervical cancer screening were also important contributors of observed inequalities. Conclusion Socioeconomic inequalities in HPV-related knowledge and vaccination uptake are evident in China. Interventions to diffuse HPV-related information for disadvantaged groups are helpful to reduce these inequalities. Providing low or no-cost HPV vaccination and ensuring accessibility of vaccines in rural areas are also considered to be beneficial.
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Affiliation(s)
- Xiaoqian Gong
- Administrative Office, Yuebei People's Hospital, Medical College, Shantou University, Shaoguan, Guangdong, China
| | - Jing Xu
- Quality Management Department, Yuebei People's Hospital, Medical College, Shantou University, Shaoguan, Guangdong, China
| | - Yuzhen He
- Nursing Department, Yuebei People's Hospital, Medical College, Shantou University, Shaoguan, Guangdong, China
| | - Guofang Zou
- Gynecology Department, Yuebei People's Hospital, Medical College, Shantou University, Shaoguan, Guangdong, China
| | - Jing Liu
- Administrative Office, Yuebei People's Hospital, Medical College, Shantou University, Shaoguan, Guangdong, China
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Wang S, Zheng R, Li J, Zeng H, Li L, Chen R, Sun K, Han B, Bray F, Wei W, He J. Global, regional, and national lifetime risks of developing and dying from gastrointestinal cancers in 185 countries: a population-based systematic analysis of GLOBOCAN. Lancet Gastroenterol Hepatol 2024; 9:229-237. [PMID: 38185129 PMCID: PMC10849975 DOI: 10.1016/s2468-1253(23)00366-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Gastrointestinal cancers account for a quarter of the global cancer incidence and a third of cancer-related deaths. We sought to estimate the lifetime risks of developing and dying from gastrointestinal cancers at the country, world region, and global levels in 2020. METHODS For this population-based systematic analysis, we obtained estimates of gastrointestinal cancer incidence and mortality rates from GLOBOCAN for 185 countries, alongside all-cause mortality and population data from the UN. Countries were categorised into quartiles of the Human Development Index (HDI). The lifetime risk of gastrointestinal cancers was estimated with a standard method that adjusts for multiple primaries, taking into account competing risks of death from causes other than cancer and life expectancy. FINDINGS The global lifetime risks of developing and dying from gastrointestinal cancers from birth to death was 8·20% (95% CI 8·18-8·21) and 6·17% (6·16-6·18) in 2020. For men, the risk of developing gastrointestinal cancers was 9·53% (95% CI 9·51-9·55) and of dying from them 7·23% (7·22-7·25); for women, the risk of developing gastrointestinal cancers was 6·84% (6·82-6·85) and of dying from them 5·09% (5·08-5·10). Colorectal cancer presented the highest risk, accounting for 38·5% of the total lifetime risk of developing, and 28·2% of dying from, gastrointestinal cancers, followed by cancers of the stomach, liver, oesophagus, pancreas, and gallbladder. Eastern Asia has the highest lifetime risks for cancers of the stomach, liver, oesophagus, and gallbladder, Australia and New Zealand for colorectal cancer, and Western Europe for pancreatic cancer. The lifetime risk of gastrointestinal cancers increased consistently with increasing level of HDI; however, high HDI countries (the third HDI quartile) had the highest death risk. INTERPRETATION The global lifetime risk of gastrointestinal cancers translates to one in 12 people developing, and one in 16 people dying from, gastrointestinal cancers. The identified high risk and observed disparities across countries warrants context-specific targeted gastrointestinal cancer control and health systems planning. FUNDING Beijing Nova Program, CAMS Innovation Fund for Medical Sciences, and Talent Incentive Program of Cancer Hospital, CAMS (Hope Star).
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Affiliation(s)
- Shaoming Wang
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rongshou Zheng
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiayue Li
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongmei Zeng
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Li
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ru Chen
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kexin Sun
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bingfeng Han
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Wenqiang Wei
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Zheng R, Wang S, Zhang S, Zeng H, Chen R, Sun K, Li L, Bray F, Wei W. Global, regional, and national lifetime probabilities of developing cancer in 2020. Sci Bull (Beijing) 2023; 68:2620-2628. [PMID: 37821267 PMCID: PMC10640926 DOI: 10.1016/j.scib.2023.09.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 06/09/2023] [Accepted: 09/22/2023] [Indexed: 10/13/2023]
Abstract
The lifetime risk of cancer is a measure of the cumulative risk of cancer over a specific age range and has a clear, intuitive appeal. However, comparative assessments of cancer-specific risk across populations are limited. We used the adjusted for multiple primaries method to estimate the lifetime risk of cancer from the obtained data from GLOBOCAN for 185 countries/regions for the year 2020, alongside all-cause mortality and population data from the United Nations. The estimated global lifetime risk of cancer from birth to death was 25.10% (95% confidence interval (CI): 25.08%-25.11%) in 2020; the risk was 26.27% (95% CI: 26.24%-26.30%) in men and 23.96% (95% CI: 23.93%-23.98%) in women. Significant differences were observed in the risks between countries/regions within world areas and by the human development level. The lifetime risk of cancer was 38.48%, 25.38%, 11.36%, and 10.34% in countries/regions with very high, high, medium, and low Human Development Index, respectively. Globally, prostate and breast cancers were associated with the greatest lifetime risks among men and women (4.65% and 5.90%, respectively). The lifetime risk of cancer decreased with age, with a remaining risk of 12.61% (95% CI: 12.60%-12.63%) from the age of 70 years. The lifetime risk from birth to death translates to approximately one in four persons developing cancer, with men and women having similar risk levels. The identified age-specific variations in cancer risk at the population level can provide crucial information to support targeted cancer prevention and health system planning.
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Affiliation(s)
- Rongshou Zheng
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Shaoming Wang
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Siwei Zhang
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Hongmei Zeng
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Ru Chen
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Kexin Sun
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Li Li
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon 69366, France.
| | - Wenqiang Wei
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
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Santos MDO, Lima FCDSD, Martins LFL, Oliveira JFP, Almeida LMD, Cancela MDC. Estimativa de Incidência de Câncer no Brasil, 2023-2025. REVISTA BRASILEIRA DE CANCEROLOGIA 2023. [DOI: 10.32635/2176-9745.rbc.2023v69n1.3700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Introdução: O câncer é um problema de saúde pública mundial. Na última década, houve um aumento de 20% na incidência e espera-se que, para 2030, ocorram mais de 25 milhões de casos novos. Estimativas do número de casos novos de câncer são uma ferramenta poderosa para fundamentar políticas públicas e alocação racional de recursos para o combate ao câncer. A vigilância do câncer é um elemento crucial para planejamento, monitoramento e avaliação das ações de controle do câncer. Objetivo: Estimar e descrever a incidência de câncer no país, Regiões geográficas, Unidades da Federação, Distrito Federal e capitais, por sexo, para o triênio 2023-2025. Método: As informações foram extraídas do Sistema de Informação sobre Mortalidade e dos Registros de Câncer de Base Populacional. Foram estimados os casos novos e suas respectivas taxas de incidência pelos modelos de predição tempo-linear ou pela razão de incidência e mortalidade. Resultados: São esperados 704 mil casos novos de câncer para o triênio 2023-2025. Excetuando o câncer de pele não melanoma, ocorrerão 483 mil casos novos. O câncer de mama feminina e o de próstata foram os mais incidentes com 73 mil e 71 mil casos novos, respectivamente. Em seguida, o câncer de cólon e reto (45 mil), pulmão (32 mil), estômago (21 mil) e o câncer do colo do útero (17 mil). Conclusão: No Brasil, por suas dimensões continentais e heterogeneidade, em termos de território e população, o perfil da incidência reflete a diversidade das Regiões geográficas, coexistindo padrões semelhantes ao de países desenvolvidos e em desenvolvimento.
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Bao H, Wang L, Brown M, Zhang M, Hunt K, Di J, Zhao Z, Cong S, Fan J, Fang L, Wang L. A nationally quasi-experimental study to assess the impact of partial organized breast and cervical cancer screening programme on participation and inequalities. BMC Cancer 2020; 20:1191. [PMID: 33276761 PMCID: PMC7716588 DOI: 10.1186/s12885-020-07686-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 11/24/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Organized breast and cervical cancer screening programme could only provide services at no cost for a fraction of socioeconomic-deprived women in China and other low-resource countries, however, little evidence exists for whether such a programme effectively affect the participation and inequalities at the population level. METHODS We used individual-level data from a nationally cross-sectional survey in 2014-2015 for breast and cervical cancer screening participation. Data for intervention and comparison grouping were from 2009 to 2014 national breast and cervical cancer screening programme, and counties covered by the programme were divided into intervention group. We assessed the impact of the intervention on the participation rates and the magnitude of inequalities with two approaches: multivariable multilevel logistic regressions adjusting for individual- and region-level covariates; and a difference analysis combined with propensity score matching that estimated the average intervention effect. RESULTS Of 69,875 included women aged 35-64 years, 21,620 were classified into the intervention group and 43,669 into the comparison group for breast cancer screening; and 31,794 into the intervention group, and 33,682 into the comparison group for cervical cancer screening. Participation rate was higher in intervention group than comparison group for breast cancer screening (25.3, 95% confidential interval [CI], 22.8-27.7%, vs 19.1, 17.4-20.7%), and cervical cancer screening (25.7, 23.8-27.7%, vs 21.5, 19.6-23.5%), respectively. Intervention significantly increased the likelihood of participation for both breast cancer and cervical cancer screening in overall women, rural women and urban women, whereas the effect was significantly higher in rural women than urban women. The average intervention effect on the participation rate was an increase of 7.5% (6.7-8.2%) for breast cancer screening, and 6.8% (6.1-7.5%) for cervical cancer screening, respectively. The inequalities were significantly decreased by 37-41% (P < 0.001) between rural and urban, however, were slightly decreased or even increased in terms of age, education status, and household income. CONCLUSIONS Organized breast and cervical cancer screening programme targeting for a fraction of women could increase the participation rates at population level, however, it could not significantly affect socioeconomic-introduced inequalities. Further studies are need to conduct time-series analyses and strengthen the causal correlation.
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Affiliation(s)
- Heling Bao
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Limin Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Matthew Brown
- Center for Global Health, China Office, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Mei Zhang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Katherine Hunt
- Susan G. Komen, 5005 LBJ Freeway, Suite 526, Dallas, TX, 75244, USA
| | - Jiangli Di
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, 12 Dahuisi Road, Haidian District, Beijing, 100081, China
| | - Zhenping Zhao
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Shu Cong
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Jing Fan
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Liwen Fang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Linhong Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, China.
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Lortet-Tieulent J, Georges D, Bray F, Vaccarella S. Profiling global cancer incidence and mortality by socioeconomic development. Int J Cancer 2020; 147:3029-3036. [PMID: 32449164 DOI: 10.1002/ijc.33114] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/01/2020] [Accepted: 05/06/2020] [Indexed: 01/22/2023]
Abstract
Economic and living conditions have improved over time in most countries, although often in association with detrimental lifestyle and environmental changes that are major determinants of cancer. In this ecological study, we assess the association between national socioeconomic levels and incidence and mortality rates for all cancers combined and 27 cancer types, in 175 countries. We obtained national level cancer incidence and mortality estimates for 2018 from GLOBOCAN and computed an index of socioeconomic development based on national education and income levels extracted from the United Nations Development Programme. Cancer incidence rates are strongly positively associated with the national socioeconomic level for all cancers combined and for a large number of cancer types, in both sexes. Conversely, the association between socioeconomic development and cancer mortality rates is less clear. The most common pattern for type-specific cancers is an increasing incidence rate with a relatively stable mortality rate as socioeconomic development increases. Despite the high incidence rates for many cancer types, mortality rates are relatively low in high-income countries, partly due to the availability of early detection and effective treatments. As socioeconomic development continues to rise, countries with currently low- and medium-development levels may experience large increases in the incidence of several cancers. Given the limited resources and lack of infrastructure, increases in incidence rates in low-income countries will likely be paralleled by increases in mortality rates. Efforts to plan, implement and evaluate prevention programs must therefore be considered as greater priorities in Low- and Middle-income countries.
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Affiliation(s)
- Joannie Lortet-Tieulent
- Section of Cancer Surveillance, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Damien Georges
- Infections and Cancer Epidemiology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Salvatore Vaccarella
- Section of Cancer Surveillance, International Agency for Research on Cancer, World Health Organization, Lyon, France
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Gatellier L, Matsuda T, Sabapathy K, Dai M, Dewi LKM, Huong TT, Kardinah K, Thuan TV, Park JB, He J, Nansalmaa E, Luvsandorj B, Hwang WYK, Sengar M, Pramesh CS, Suzuki T. An Asian Body to Tackle Cancers in Asia - The Asian National Cancer Centers Alliance. Asian Pac J Cancer Prev 2020; 21:1207-1212. [PMID: 32458623 PMCID: PMC7541889 DOI: 10.31557/apjcp.2020.21.5.1207] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Indexed: 12/24/2022] Open
Abstract
The socioeconomic burden of cancer is growing rapidly in the Asian region, with a concentrated burden on low- and middle- income countries. The residents of this region, representing almost 60% of the global population, demonstrate an eclectic and complex nature, with huge disparities in ethnicity, sociocultural practices among others. The Asian National Cancer Centers Alliance (ANCCA) was established in 2005 by heads of several national cancer centers (NCCs) in the region to address common issues and concerns among Asian countries. During the first 13 years of ANCCA’s existence, the participating NCCs’ senior managers paved the way toward collaboration through transparent sharing of key facts and activities. Concrete achievements of the Alliance include the Asia Tobacco-Free Declaration, the establishment of the ANCCA Constitution in 2014 as well as the creation of an official website more recently. In November 2019, the most active ANCCA members (China, India, Indonesia, Japan, Korea, Mongolia, Singapore, Thailand, and Vietnam) strengthened the bonds of the entity with the clear aim to halt the increase in cancer and mortality rates in Asian countries by 2030. New opportunities including accelerated cooperation between members as well as collaboration with external and multidisciplinary stakeholders at local, regional and international levels are an essential step to most effectively tackle cancers in Asia.
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Affiliation(s)
- Laureline Gatellier
- National Cancer Center, Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Tomohiro Matsuda
- National Cancer Center, Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Kanaga Sabapathy
- National Cancer Centre Singapore, 11, Hospital Crescent, Singapore
| | - Min Dai
- National Cancer Center, China, 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Luh Komang Mela Dewi
- Dharmais Hospital - National Cancer Center, Jalan Letjend S. Parman No.84-89 Kecamatan Palmerah, Kota Jakarta Barat, DKI Jakarta, 11420, Indonesia
| | - Tran Thanh Huong
- National Cancer Institute & Hanoi Medical University, Hanoi, Vietnam
| | - Kardinah Kardinah
- Dharmais Hospital - National Cancer Center, Jalan Letjend S. Parman No.84-89 Kecamatan Palmerah, Kota Jakarta Barat, DKI Jakarta, 11420, Indonesia
| | - Tran Van Thuan
- National Cancer Institute & Hanoi Medical University, Hanoi, Vietnam
| | - Jong Bae Park
- National Cancer Center of Korea, 323 Ilsan-ro, Ilsandong-gu, Goyang-si Gyeonggi-do, 10408, Republic of Korea
| | - Jie He
- National Cancer Center, China, 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Erdenekhuu Nansalmaa
- National Cancer Center of Mongolia, Nam Yan Ju Street, 13370 Ulaanbaatar, Mongolia
| | | | | | - Manju Sengar
- Tata Memorial Hospital, Dr. E, Dr Ernest Borges Rd, Parel, Mumbai, Maharashtra 400012, India
| | - C S Pramesh
- Tata Memorial Hospital, Dr. E, Dr Ernest Borges Rd, Parel, Mumbai, Maharashtra 400012, India
| | - Tatsuya Suzuki
- National Cancer Center, Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
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Bucchi D, Chiavarini M, Bianconi F, Galeotti ME, Gili A, Stracci F. Immigration, screening, and cervical cancer incidence: an application of Age-Period-Cohort analysis. Eur J Cancer Prev 2019; 28:529-536. [PMID: 30431461 PMCID: PMC6784855 DOI: 10.1097/cej.0000000000000495] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/01/2018] [Indexed: 11/26/2022]
Abstract
Cervical cancer (CC) control is based on the implementation of effective screening programs. In the coming years, human papilloma virus vaccination coverage will contribute considerably toward cancer prevention. In Italy, where an organized screening program has been implemented, immigration from low/middle-income countries with a high prevalence of human papilloma virus infections has increased steadily over the last decades. To assess the impact of screening efforts in counteracting background changes, we analyzed the incidence trends of cervical intraepithelial neoplasia grade 3 carcinomas in situ (CIS) and invasive CC from 1994 to 2013 through an Age-Period-Cohort model using data of a regional population-based registry. Moreover, using Joinpoint regression, we compared the incidence of cervical lesions in native women with that observed in foreign-born women, highlighting the differences in age and screening status. The results indicate that the CC incidence trend decreased in Italian women (annual percent change = -2.7*%, 95% confidence interval = -4.3; -1.1), but increased (APC = 12.2*%, 95% confidence interval = 7.6; 17.0) in immigrants. For CIS, incidence rates show a growing trend in both groups, especially in women born abroad. For cancer, no marked changes in period-specific incidence rate ratios were detected until around 2000, when we found a slight decrease, followed by an increase. For CIS, we estimate an important upward trend in cohort-specific risks. The favorable effect of screening in preventing an increase in CC incidence has been counteracted by the progressive increase in immigrants from high-risk countries, where it is of increasing relevance to extend the use of vaccination.
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Affiliation(s)
- Dania Bucchi
- School of Specialization in Hygiene and Preventive Medicine
| | - Manuela Chiavarini
- Department of Experimental Medicine, Public Health Section, University of Perugia, Perugia
| | | | | | | | - Fabrizio Stracci
- School of Specialization in Hygiene and Preventive Medicine
- Department of Experimental Medicine, Public Health Section, University of Perugia, Perugia
- Umbria Cancer Registry, Umbria, Italy
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Kandolf Sekulovic L, Guo J, Agarwala S, Hauschild A, McArthur G, Cinat G, Wainstein A, Caglevic C, Lorigan P, Gogas H, Alvarez M, Duncombe R, Lebbe C, Peris K, Rutkowski P, Stratigos A, Forsea AM, De La Cruz Merino L, Kukushkina M, Dummer R, Hoeller C, Gorry C, Bastholt L, Herceg D, Neyns B, Vieira R, Arenberger P, Bylaite-Bucinskiene M, Babovic N, Banjin M, Putnik K, Todorovic V, Kirov K, Ocvirk J, Zhukavets A, Ymeri A, Stojkovski I, Garbe C. Access to innovative medicines for metastatic melanoma worldwide: Melanoma World Society and European Association of Dermato-oncology survey in 34 countries. Eur J Cancer 2018; 104:201-209. [PMID: 30388700 DOI: 10.1016/j.ejca.2018.09.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 09/12/2018] [Indexed: 12/19/2022]
Abstract
According to data from recent studies from Europe, a large percentage of patients have restricted access to innovative medicines for metastatic melanoma. Melanoma World Society and European Association of Dermato-oncology conducted a Web-based survey on access to first-line recommended treatments for metastatic melanoma by current guidelines (National Comprehensive Center Network, European Society for Medical Oncology [ESMO] and European Organization for Research and Treatment of Cancer/European Association of Dermato-oncology/European dermatology Forum) among melanoma experts from 27 European countries, USA, China, Australia, Argentina, Brazil, Chile and Mexico from September 1st, 2017 to July 1st, 2018. Data on licencing and reimbursement of medicines and the number of patient treated were correlated with the data on health expenditure per capita (HEPC), Mackenbach score of health policy performance, health technology assessment (HTA), ASCO and ESMO Magnitude of clinical benefit scale (ESMO MCBS) scores of clinical benefit and market price of medicines. Regression analysis for evaluation of correlation between the parameters was carried out using SPSS software. The estimated number of patients without access in surveyed countries was 13768. The recommended BRAFi + MEKi combination and anti-PD1 immunotherapy were fully reimbursed/covered in 19 of 34 (55.8%) and 17 of 34 (50%) countries, and combination anti-CTLA4+anti-PD1 in was fully covered in 6 of 34 (17.6%) countries. Median delay in reimbursement was 991 days, and it was in significant correlation with ESMO MCBS (p = 0.02), median market price (p = 0.001), HEPC and Mackenbach scores (p < 0.01). Price negotiations or managed entry agreements (MEAs) with national authorities were necessary for reimbursement. In conclusion, great discrepancy exists in metastatic melanoma treatment globally. Access to innovative medicines is in correlation with economic parameters as well as with healthcare system performance parameters. Patient-oriented drug development, market access and reimbursement pathways must be urgently found.
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Affiliation(s)
- L Kandolf Sekulovic
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia.
| | - J Guo
- Department of Urology and Melanoma, Peking University Cancer Hospital & Institute, Beijing, PR China
| | - S Agarwala
- St. Luke's University Hospital and Temple University, Bethlehem, USA
| | - A Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany
| | - G McArthur
- Divisions of Research and Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
| | - G Cinat
- Médica Oncóloga Instituto de Oncología Angel Roffo, Universidad de Buenos Aires Fundación CIDEA, Buenos Aires, Argentina
| | - A Wainstein
- Institute of Post-graduation, Faculdade de Ciências Médicas de Minas Gerais (FCM-MG) - Belo Horizonte (MG), Brazil
| | - C Caglevic
- Medical Oncology Service, Oncology Department, Clinica Alemana Santiago, Faculty of Medicine Clinica Alemana-Universidad Del Desarrollo, Santiago, Chile
| | - P Lorigan
- Institute of Cancer Sciences, University of Manchester, The Christie NHS Foundation Trust, Manchester, UK
| | - H Gogas
- 1(st)Department of Internal Medicine, Laiko Hospital and 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - M Alvarez
- Medico en Instituto Nacional de Cancerologia, Mexico City Area, Mexico
| | - R Duncombe
- Institute of Cancer Sciences, University of Manchester, The Christie NHS Foundation Trust, Manchester, UK
| | - C Lebbe
- APHP Dermatology Department, University Paris 7 Diderot, INSERM U976, PARIS, France
| | - K Peris
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - P Rutkowski
- Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland
| | - A Stratigos
- 1(st)Department of Internal Medicine, Laiko Hospital and 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - A-M Forsea
- Carol Davila University of Medicine and Pharmacy, Elias University Hospital Bucharest, Romania
| | - L De La Cruz Merino
- Department of Clinical Oncology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | - R Dummer
- UniversitätsSpital Zürich-Skin Cancer Center, University Hospital, Zürich, Switzerland
| | - C Hoeller
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - C Gorry
- National Centre for Pharmacoeconomics, Old Stone Building, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland
| | - L Bastholt
- Department of Oncology, Odense University Hospital, Denmark
| | - D Herceg
- Department of Oncology, University Hospital Zagreb, Croatia
| | - B Neyns
- Department of Medical Oncology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - R Vieira
- Department of Dermatology, Medical Faculty, University of Coimbra, Portugal
| | - P Arenberger
- Department of Dermatovenereology, Charles University 3rd Faculty of Medicine and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | | | - N Babovic
- Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | - M Banjin
- Department of Oncology, University Hospital Sarajevo, Bosnia and Herzegovina
| | - K Putnik
- North Estonia Medical Centre, Tallinn, Estonia
| | - V Todorovic
- Clinic for Oncology and Radiotherapy, Podgorica, Montenegro
| | - K Kirov
- Clinic of Oncodermatology, National Cancer Center, Sofia, Bulgaria
| | - J Ocvirk
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - A Zhukavets
- Belarusian Medical Academy of Postgraduate Education (BelMAPE), Minsk, Belarus
| | - A Ymeri
- University Hospital Mother Theresa, Tirana, Albania
| | - I Stojkovski
- University Clinic of Radiotherapy and Oncology, Skopje, Macedonia
| | - C Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
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Abstract
Epidemiological methods are essential for the discovery of cancer risks and prognostic factors as well as for the evaluation of cancer prevention measures. In this review, we discuss epidemiological surveillance procedures for data collection and processing to guide and evaluate the consequences of anticancer efforts for populations, assess the identification of cancer risk factors, examine barriers to cancer screening and recommended rules for early diagnosis programs. Epidemiological studies have shown that hindrances to cancer information assessment are currently encountered in developing countries. Known cancer risk factors include social determinants, lifestyle factors, occupational exposures, infectious agents, and genetic and epigenetic alterations. Challenges remain in studying the effectiveness of cancer screening; screening can have detrimental effects, and few cancers clearly benefit from screening. Currently, epidemiology faces the challenge of dealing with distinct levels of data, including factors related to social status, lifestyle and genetics, to reconstruct the causal traits of cancer. Additionally, translating epidemiological knowledge into cancer control demands more implementation studies in the population.
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Affiliation(s)
- Tatiana N Toporcov
- Departamento de Epidemiologia, Faculdade de Saude Publica, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Victor Wünsch Filho
- Departamento de Epidemiologia, Faculdade de Saude Publica, Universidade de Sao Paulo, Sao Paulo, SP, BR
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11
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de Vries E, Arroyave I, Pardo C. Re-emergence of educational inequalities in cervical cancer mortality, Colombia 1998–2015. J Cancer Policy 2018. [DOI: 10.1016/j.jcpo.2017.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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12
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Kangmennaang J, Onyango EO, Luginaah I, Elliott SJ. The next Sub Saharan African epidemic? A case study of the determinants of cervical cancer knowledge and screening in Kenya. Soc Sci Med 2017; 197:203-212. [PMID: 29253722 DOI: 10.1016/j.socscimed.2017.12.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 12/04/2017] [Accepted: 12/11/2017] [Indexed: 01/28/2023]
Abstract
Early cervical cancer screening has been shown to be beneficial in reducing cervical cancer related deaths. Despite the benefits of early cervical cancer screening, uptake remains limited, with wide disparities in access and uptake in most developing countries. As part of a larger study, this paper uses a socio-ecological framework to explain the determinants of cervical cancer knowledge and screening among women of reproductive age (15-49 years) in Kenya. We conducted a multilevel analysis of cervical cancer knowledge (n = 11,138) and screening (n = 10,333) using the 2014 Kenya Demographic and Health Survey (KDHS). Results show regional disparities in cancer knowledge and the utilization of cervical cancer screening services; regions with high wealth inequality (OR = 0.70, 95% CI [0.56-0.87]) emerged as vulnerable regions where women were less likely to screen for cervical cancer. Gender equity, health insurance coverage and education level significantly predicted cervical cancer screening rates. Results further revealed regional as well as rural-urban wealth inequalities in cervical cancer screening. We argue that given that Kenyan women are highly exposed to human papilloma virus (HPV) due to the legacy of human immunodeficiency virus (HIV) in the country, cervical cancer may be the next epidemic if integrated measures are not adopted to increase cervical cancer knowledge and overcome the barriers to utilizing early screening services. The paper concludes with policy recommendations and directions for future research.
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Affiliation(s)
- Joseph Kangmennaang
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, ON, Canada.
| | - Elizabeth O Onyango
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, ON, Canada; Department of Community Health and Management, Masinde Muliro University of Science and Technology, Kakamega, Kenya
| | - Isaac Luginaah
- Department of Geography, Western University, London, ON, Canada
| | - Susan J Elliott
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, ON, Canada
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13
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Alternative Splicing in Breast Cancer and the Potential Development of Therapeutic Tools. Genes (Basel) 2017; 8:genes8100217. [PMID: 28981467 PMCID: PMC5664086 DOI: 10.3390/genes8100217] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 08/22/2017] [Accepted: 08/22/2017] [Indexed: 12/19/2022] Open
Abstract
Alternative splicing is a key molecular mechanism now considered as a hallmark of cancer that has been associated with the expression of distinct isoforms during the onset and progression of the disease. The leading cause of cancer-related deaths in women worldwide is breast cancer, and even when the role of alternative splicing in this type of cancer has been established, the function of this mechanism in breast cancer biology is not completely decoded. In order to gain a comprehensive view of the role of alternative splicing in breast cancer biology and development, we summarize here recent findings regarding alternative splicing events that have been well documented for breast cancer evolution, considering its prognostic and therapeutic value. Moreover, we analyze how the response to endocrine and chemical therapies could be affected due to alternative splicing and differential expression of variant isoforms. With all this knowledge, it becomes clear that targeting alternative splicing represents an innovative approach for breast cancer therapeutics and the information derived from current studies could guide clinical decisions with a direct impact in the clinical advances for breast cancer patients nowadays.
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14
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More than 5000 patients with metastatic melanoma in Europe per year do not have access to recommended first-line innovative treatments. Eur J Cancer 2017; 75:313-322. [DOI: 10.1016/j.ejca.2017.01.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 01/21/2017] [Indexed: 12/31/2022]
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15
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McCartney DMA, Byrne DG, Cantwell MM, Turner MJ. Cancer incidence in Ireland—the possible role of diet, nutrition and lifestyle. J Public Health (Oxf) 2016. [DOI: 10.1007/s10389-016-0769-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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